This study was carried out to evaluate the diagnostic value of thyroid ultrasonography in infants with congenital hypothyroidism detected by neonatal screening programs. Our aims were to describe the ultrasound appearance of thyroid gland and to correlate ultrasound findings with clinical and radionuclide data in various types of congenital hypothyroidism: athyreosis, ectopic or hypoplastic gland, enzyme defects. Ultrasound evaluation of the thyroid gland was performed in hypothyroid infants (no. 24) and in controls (no. 20); patients were examined without sedation and in the supine position with the neck hyperextended. An accurate examination of neck and sublingual areas was performed in order to visualize thyroid tissue. With this study we could differentiate the cases where thyroid gland was normal in size, location and homogenity (euthyroid controls) from the cases of hypothyroidism. ln these patients a normally located small gland could be seen in the hypoplastic thyroid gland, while a normally located increased size thyroid gland suggested an enzyme defect. When the thyroid gland couldn’t be seen in paratracheal areas and the radionuclide scan confirmed the diagnosis of thyroid disgenesis, an ultrasound study of sublingual area was performed in order to visualize ectopic thyroid tissue at the base of the tongue. Ultrasounds couldn’t visualize ectopic glands in all the cases shown by radionuclide scan. The failure in detecting some ectopic thyroid glands may be explained by the small size of the thyroid gland, and tongue’s similar ecogenicity, and by our limited experience. ln conclusion ultrasounds are able to differentiate hypothyroid infants with a normally located thyroid gland (enzyme defect, hypoplastic thyroid gland) from disgenesis (athyreosis, ectopic thyroid gland). When ultrasounds didn’t show ectopic thyroid tissue, the discrimination between athyreosis and small ectopic gland needed a radionuclide scan.
Thyroid ultrasonography in the neonatal diagnosis of congenital hypothyroidism (L'ecografia tiroidea nella diagnosi neonatale dell'ipotiroidismo congenito)
BONA, Gianni;SILVESTRO, Leandra;
1987-01-01
Abstract
This study was carried out to evaluate the diagnostic value of thyroid ultrasonography in infants with congenital hypothyroidism detected by neonatal screening programs. Our aims were to describe the ultrasound appearance of thyroid gland and to correlate ultrasound findings with clinical and radionuclide data in various types of congenital hypothyroidism: athyreosis, ectopic or hypoplastic gland, enzyme defects. Ultrasound evaluation of the thyroid gland was performed in hypothyroid infants (no. 24) and in controls (no. 20); patients were examined without sedation and in the supine position with the neck hyperextended. An accurate examination of neck and sublingual areas was performed in order to visualize thyroid tissue. With this study we could differentiate the cases where thyroid gland was normal in size, location and homogenity (euthyroid controls) from the cases of hypothyroidism. ln these patients a normally located small gland could be seen in the hypoplastic thyroid gland, while a normally located increased size thyroid gland suggested an enzyme defect. When the thyroid gland couldn’t be seen in paratracheal areas and the radionuclide scan confirmed the diagnosis of thyroid disgenesis, an ultrasound study of sublingual area was performed in order to visualize ectopic thyroid tissue at the base of the tongue. Ultrasounds couldn’t visualize ectopic glands in all the cases shown by radionuclide scan. The failure in detecting some ectopic thyroid glands may be explained by the small size of the thyroid gland, and tongue’s similar ecogenicity, and by our limited experience. ln conclusion ultrasounds are able to differentiate hypothyroid infants with a normally located thyroid gland (enzyme defect, hypoplastic thyroid gland) from disgenesis (athyreosis, ectopic thyroid gland). When ultrasounds didn’t show ectopic thyroid tissue, the discrimination between athyreosis and small ectopic gland needed a radionuclide scan.
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